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stimulate gluconeogenesis in the liver and decrease uptake of glucose into the muscle, lymphatic, and adipose cells results in elevated glucose
decreased proliferation of fibroblasts in connective tissue in concert with poor protein synthesis leads to poor wound healing
highest mineralocorticoid potency (aldosterone) cortisone, hydrocortisone
moderate mineralocorticoid potency prednisone, prednisolone, florinef
low mineralocorticoid potency triamcinolone, dexamethasone, methylprednisolone, betamethasone
high mineralocorticoid potency drugs can cause elevated BP, salt and water retention, increased excretion of potassium
all corticosteroids increase excretion of calcium, can create problems for postmenopausal women or others at risk for osteoporosis
pregnancy category C: have caused cleft palate, stillborn, decreased fetal size
glucocorticoids at 7.5mg/day or > for > 6 months can cause rapid loss of trabecular bone in the spine, hip, and forearm
if risk factors of PUD recommended prophylaxis PPI's or h2 blockers
primary and secondary adrenocortical insufficiency primary no common is US; secondary more common due to steroid withdrawal
choice for treating inflammation, ? mineralocorticoid potency low, methylprednisolone, dexamethasone
use for immunosuppression most commonly prednisone
if used for rheumatoid arthritis at < 7.5 mg/d for short term use supplement with bisphosphonate (Fosamax), and calcium, vit. d supplements
for chronic corticosteroid therapy dosing may be every other day to help minimize HPA axis suppression
to best match natural body rhythm, diurnal, take medication before what time 9 am
signs of adrenal insufficiency anorexia, nausea, weakness, fatigue, dyspnea, hypotension, hypoglycemia
Created by: heatherbrown2020